Worked example

Permanent link /examples/automated-eligibility-denial

Automated eligibility denial

Eligibility denial with a named owner, appeal path, and enforceable remedy clocks.

Scenario

Eligibility decisions require contestability

Eligibility outcomes must ship with receipts, owners, clocks, and remedies.

Receipt

Receipt issued at decision time

Receipts make the denial traceable and contestable.

{
  "schema_version": "1.0.0",
  "receipt_id": "RCP-2026-1124",
  "issued_at": "2026-05-06T08:27:41Z",
  "owner": { "name": "Eligibility Operations", "role": "System owner" },
  "subject": { "id": "app-99114", "type": "application" },
  "action": { "class": "WRITE", "description": "Deny eligibility", "reversible": true },
  "decision": { "decision_type": "eligibility_denial", "reason_codes": ["INCOME-MISMATCH"] },
  "clocks": { "ack": { "hours": 4 }, "review": { "hours": 48 }, "remedy": { "hours": 120 } },
  "appeal_path": { "url": "/appeals/eligibility", "channel": "in-product form" }
}

Clocks

Visible acknowledgment, review, and remedy clocks

Clocks are visible to applicants and reviewers.

Ack clock

4 hours

Owner confirms responsibility and shares a review ETA.

Review clock

48 hours

Human reviewer validates the denial or flags an exception.

Remedy clock

120 hours

Reversal, compensation, or safe fallback is delivered.

Exceptions

Exceptions must preserve the appeal path

Exceptions can delay remedy, but never remove contestation.

  • Data-quality exceptions require a documented re-verification plan.
  • Legal exceptions require steward sign-off and review cadence.
  • Exceptions are logged in the Exceptions framework.

Remedy

Remedy path is mandatory

Remedy must be visible, time-bound, and actionable.

  • Reverse the denial when verification succeeds.
  • Offer assisted review for high-burden applicants.
  • Provide clear next steps and evidence requests.

Bindings

Bind eligibility decisions to enforceable controls

Tie eligibility decisions to evidence packs and bindings.